Self-expandable stents improve survival in esophageal stenosis

Self-expandable stents in patients with inoperable malignant esophageal stenosis has few complications and results in long survival in comparison with similar studies, reports March's Scandanavian Journal of Gastroenterology.

The research team reported on survival and complications after insertion of these self-expandable stents.

Data were gathered retrospectively from the medical records of 92 consecutive patients between 1994 and 2003.

The researchers assessed 68 men and 24 women, with a median age of 72 years.

The team reported that 61 patients had stenosis from cancer of the esophagus, 26 of the gastric cardia, and 5 of the lung.

A further 4 patients had stenosis from cancer located mainly above the carina, 62 below the carina, and 26 at the gastro-esophageal junction.

The researchers noted that 1 uncovered stent and 6 different covered stents were used.

30-day mortality was 19%, and 7% survived more than 1 year

Scandanavian Journal of Gastroenterology

The mean survival times after stenting was 125 days.

The team found that 30-day mortality was 19%, and 7% survived more than 1 year.

Survival was neither significantly influenced by division of the patients into diagnostic subgroups nor by comparison of the 3 most frequently used stents.

The team noted that 1, 2, 3 and 4 stents were received by 76, 11, 4 and 1 of the patients, respectively.

There was no stent-related mortality.

The team observed that complications included bleeding, and stent migration.

Recurrent stenosis occurred from both tumor overgrowth and ingrowth when using uncovered stents.

The team found that 14% of patients were restented because of recurrent stenosis, including fistula formation to the left main bronchus, and stent migration.

Dr Johnson's team concludes, “Use of self-expandable stents in patients with inoperable malignant esophageal stenosis carried few complications and resulted in relatively long survival in comparison with similar studies.”